Fillable 2021 Membership Application (Electrical Association)

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2021 Membership Application (Electrical Association)

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Country of origin: US
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GOVERNMENT MEMBERSHIP $440
2021 Membership Application
WHICH MEMBER BENEFITS INTEREST YOU THE MOST?
Government Membership is for government agencies who employee
a master electrician or licensed electrical personnel.
Newsletters and Government Action Alerts
Lobbying at Legislature
Discounts on Class/Apprentice Training
Networking Opportunities
Discount Programs for Products and Services
FreeWage&BenetReportforrespondingtosurvey
Free Electrical Toolbox Talks
FreeAWAIRManual
Discounts on Private, Customized On-Site Training
Free 8 hrs Association Code class for you or one of your
employees
I am also registering for a class and need a membership discount! If you are registering for a class,
check this box and we will apply the membership discount when we process your total order.
Registering
for a class?
NEW MEMBER INFORMATION:
Yearly Dues: $440
Check enclosed Credit Card (Visa, Mastercard, AmEx)
Credit card #: ________________________________________________________________________________________
Exp. Date: __________ Security Code:__________ Name on Card: _____________________________________________
Enrollinautopay(dueswillbedraftedfromyourcreditcardonleannually)
BillingAddress(ifdierentthanabove):
_____________________________________________________________________________
ENCLOSE PAYMENT WITH APPLICATION:
Return your membership application with payment:
MAIL
3100 Humboldt Ave S
Minneapolis, MN 55408
EMAIL
info@
electricalassociation.com
PHONE
612-827-6117
800-829-6117
FAX
612-827-0920
Company: _________________________________________________________________________________
Designated Contact: _________________________________________________________________________
License #: _________________________________________________________________________________
Address: __________________________________________________________________________________
City/State/Zip: ______________________________________________________________________________
Phone: ____________________________________________________________________________________
Fax: ______________________________________________________________________________________
Email: _____________________________________________________________________________________
Web Site: _________________________________________________________________________________
# of Employees: ____________________________________________________________________________
IBEW Merit Shop CLA
Referredby: _______________________________________________________________________________
How did you hear about us? ___________________________________________________________________
ElectricalAssociationmemberswillreceivepromotionalemailsonaregularbasisforproductsandservicesoeredtoassisttheir
business needs.
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2021 Membership Application (Electrical Association)

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Completed 17 July 2021

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